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At least 235 records · Page 13Linked to original sources
PubMed2006

Impact of UCSF criteria according to pre- and post-OLT tumor features: analysis of 479 patients listed for HCC with a short waiting time.

Orthotopic liver transplantation (OLT) indication for hepatocellular carcinoma (HCC) is currently based on the Milan criteria. The University of California, San Francisco (UCSF) recently proposed an expansion of the selection criteria according to tumors characteristics on the explanted liver. This study: 1) assessed the validity of these criteria in an independent large series and 2) tested for the usefulness of these criteria when applied to pre-OLT tumor evaluation. Between 1985 and 1998, 479 patients were listed for liver transplantation (LT) for HCC and 467 were transplanted. According to pre-OLT (imaging at date of listing) or post-OLT (explanted liver) tumor characteristics, patients were retrospectively classified according to both the Milan and UCSF criteria. The 5-yr survival statistics were assessed by the Kaplan-Meier method and compared by the log-rank test. Pre-OLT UCSF criteria were analyzed according to an intention-to-treat principle. Based on the pre-OLT evaluation, 279 patients were Milan+, 44 patients were UCSF+ but Milan- (subgroup of patients that might benefit from the expansion), and 145 patients were UCSF- and Milan-. With a short median waiting time of 4 months, 5-yr survival was 60.1 +/- 3.0%, 45.6 +/- 7.8%, and 34.7 +/- 4.0%, respectively (P < 0.001). The 5-yr survival was arithmetically lower in UCSF+ Milan- patients compared to Milan+ but this difference was not significant (P = 0.10). Based on pathological features of the explanted liver, 5-yr survival was 70.4 +/- 3.4%, 63.6 +/- 7.8%, and 34.1 +/- 3.1%, in Milan+ patients (n = 184), UCSF+ Milan- patients (n = 39), and UCSF- Milan- patients (n = 238), respectively (P < 0.001). However, the 5-yr survival did not differ between Milan+ and UCSF+ Milan- patients (P = 0.33). In conclusion, these results show that when applied to pre-OLT evaluation, the UCSF criteria are associated with a 5-yr survival below 50%. Their applicability is therefore limited, despite similar survival rates compared to the Milan criteria, when the explanted liver is taken into account.

California↗
PubMed1995

Classification of amino acid spin systems using PFG HCC(CO)NH-TOCSY with constant-time aliphatic 13C frequency labeling.

We have developed a useful strategy for identifying amino acid spin systems and side-chain carbon resonance assignments in small 15N-, 13C-enriched proteins. Multidimensional constant-time pulsed field gradient (PFG) HCC(CO)NH-TOCSY experiments provide side-chain resonance frequency information and establish connectivities between sequential amino acid spin systems. In PFG HCC(CO)NH-TOCSY experiments recorded with a properly tuned constant-time period for frequency labeling of aliphatic 13C resonances, phases of cross peaks provide information that is useful for identifying spin system types. When combined with 13C chemical shift information, these patterns allow identification of the following spin system types: Gly, Ala, Thr, Val, Leu, Ile, Lys, Arg, Pro, long-type (i.e., Gln, Glu and Met), Ser, and AMX-type (i.e., Asp, Asn, Cys, His, Phe, Trp and Tyr).

Amino Acid Sequence↗
PubMedDate not supplied

Liver resection for hepatocellular carcinoma (HCC) with direct removal of tumor thrombi in the main portal vein.

Since the tumor thrombus in the main portal vein appears in the terminal stage of hepatocellular carcinoma (HCC), any attempt to remove it surgically is thought to be impractical as the malignancy itself cannot be entirely removed. During the past 5 years, we have performed tumor thrombectomy combined with hepatectomy in 29 of 298 patients with HCC. This combined therapy was initially decided upon as an emergency measure to prevent impending rupture of esophageal varices, rather than to improve patient survival. Since portal flow was obtained after removal of thrombi, this condition enabled transcatheter arterial embolization (TAE) and/or percutaneous ethanol injection therapy (PEIT). Although improved patient survival was not the primary goal of the emergency operation and there was an operative mortality of 11%, half of the other patients in the present series had unexpectedly high survival rates of 1 year (52.2%), 2 years (23.2%), and 3 years (11.6%), which were significantly higher than in patients not undergoing operation (n = 22).

Aged↗
PubMed2002

Treatment of hepatocellular carcinoma (HCC) with systemic chemotherapy combining epirubicin, cisplatinum and infusional 5-fluorouracil (ECF regimen).

PURPOSE: We tested the efficacy of a systemic chemotherapy regimen combining epirubicin, cisplatinum and infusional 5-fluorouracil (ECF) in a cohort of patients with hepatocellular carcinoma (HCC) who could not be given surgical, intraarterial or percutaneous treatment. PATIENTS AND METHODS: Between January 1998 and June 2000, 21 patients with metastatic and/or locally advanced HCC complicating a fibrous liver or a well-compensated (Child A) cirrhosis were given systemic chemotherapy with the ECF regimen. Tumor responses as assessed on CT scan and in terms of survival were studied. RESULTS: Patients completed a median of five chemotherapy courses. Overall tolerance was good but eight patients developed grade 3-4 toxicity, mainly hematological, and one patient experienced a grade 4 renal toxicity. Median survival was 10 months. Actuarial survivals (+/-SD) at 6 months, 1 year and 2 years were 90.2+/-9%, 70.3+/-10% and 24.6+/-19%, respectively. Of the 21 patients, 13 died, 12 from their tumor and 1 from treatment-related renal failure. There were only three objective responses (14.5%; CI95 1-28%) but one of these corresponded to a pathological complete response. The delay to tumor progression was 5.9+/-4.7 months. CONCLUSIONS: Systemic chemotherapy using the ECF regimen gave a poor response and low survival rates. It would appear reasonable to pursue the search for potentially efficacious chemotherapy protocols using other drug combinations.

Aged↗
PubMed2006

Large-sized hepatocellular carcinoma (HCC): a neoadjuvant treatment protocol with repetitive transarterial chemoembolization (TACE) before percutaneous MR-guided laser-induced thermotherapy (LITT).

This study aims to evaluate the efficacy and safety of a neoadjuvant treatment protocol with repeated transarterial chemoembolization (TACE) before MR-guided laser-induced thermotherapy (LITT) for large-sized hepatocellular carcinomas (HCC). Repeated TACE (mean, 3.5 treatments per patient) was performed in 48 patients with neoadjuvant intention (the largest lesion was between 50 and 80 mm in diameter, and there were no more than five lesions). For the TACE treatment, we used 10 mg/m(2) mitomycin, 10 ml/m(2) Lipiodol and microspheres. The tumor volume was measured by MRI. Lipiodol retention of the tumors was evaluated with CT. After the diameter of the tumors had decreased to less than 50 mm, the patients were treated with MR-guided LITT 4 to 6 weeks after embolization. Repeated TACE reduced the tumor size in 32 patients (66.7%), forming the basis for performing MR-guided LITT procedures. These patients received one to four laser treatments (mean, 1.9 per patient) for tumor ablation, resulting in a median survival of 36.0 months after the first treatment. For the remaining patients, no reduction in tumor size was achieved in 12 patients and disease progression in 4 patients. Neoadjuvant TACE appears to be an effective treatment of large-sized HCC, which extends the indication for MR-guided LITT.

Aged↗
PubMedDate not supplied

Some properties of the histone-like protein from Crypthecodinium cohnii (HCc).

The histone-like protein from Crypthecodinium cohnii (HCc) was examined in regard to its amino acid composition and the peptide pattern resulting from protease digestion. A revised amino acid composition indicated a higher lysine and arginine content and a lower glycine content than that determined previously. Comparative peptide mapping of HCc with HTa, a histone-like protein from Thermoplasma acidophilum, and with a histone-like protein from the dinoflagellate Gyrodinium dorsum showed significant differences in the peptide patterns produced.

Amino Acids↗
PubMed2006

Characteristics at presentation and outcome of hepatocellular carcinoma (HCC) in the elderly. A study of the Cancer of the Liver Italian Program (CLIP).

PURPOSE: To describe the characteristics at presentation and the outcome of elderly patients (> or =70 years old) with HCC, a retrospective analysis using a CLIP database was performed. PATIENTS AND METHODS: The database included 650 patients. Chi2-test, logistic and Cox model were applied. RESULTS: Baseline characteristics and stage were similarly among elderly (n=158) and non-elderly (n=492) patients. More elderly patients did not receive any local treatment (56% versus 38%, p<0.0001). Age and CLIP score were independently predictive of the odds of locoregional treatment. Prognosis was worse for elderly patients with a hazard ratio of death of 1.49 (95% CI 1.20-1.86) at multivariable analysis. The survival difference disappeared when patients were compared within each treatment group, suggesting a close link between undertreatment and shorter survival. CONCLUSION: Elderly patients with HCC have a worse prognosis compared to non-elderly ones. Such difference seems the consequence of undertreatment.

Age Factors↗
PubMed1991

A radiological-pathological correlation of hepatocellular carcinoma (HCC).

The histological distribution of lipiodol within hepatocellular carcinoma (HCC) was correlated with that seen on computed tomography (CT), arteriography and high resolution plain films of 15 resected specimens. By means of special stains, the arterially administered lipiodol was shown to be maximally distributed at the periphery of large tumours and nodules. The centre of large lesions often remained unopacified. In multinodular tumours some nodules were heavily stained while others contained little or no contrast medium. In small tumours there was a more uniform distribution. In large tumours, those areas where there are large arteries (and slow flow) contained little or no lipiodol. There was also no consistent match of areas of angiographic blush with lipiodol deposition. The lipiodol patterns were poorly shown by CT when compared with high resolution films taken on a mammography unit. We conclude from this study that lipiodol on its own as an embolic agent or as a chemotherapeutic carrier has great limitations because of its peripheral and otherwise haphazard distribution in large tumours. However, such treatments might be more effective in small tumours where a greater concentration of lipiodol is likely. Nevertheless, lipiodol staining of tumours remains a useful diagnostic aid as small HCC can be difficult to visualize both on arteriography and conventional CT.

Adult↗
PubMed2002

Occurrence of HCC in asymptomatic HCV-related chronic hepatitis.

Patients with persistently normal ALT affected with HCV-related chronic hepatitis exist. The natural history of liver disease in these patients was demonstrated to be very slow and progression to cirrhosis likely absent. The case we report describes the occurrence of hepatocellular carcinoma (HCC) in a patient with persistently normal ALT affected with mild chronic hepatitis. This observation suggests that asymptomatic carriers of HCV may develop HCC that is not related to underlying liver cirrhosis.

Carcinoma, Hepatocellular↗
PubMed2006

Cost of caring for Medicare beneficiaries with Parkinson's disease: impact of the CMS-HCC risk-adjustment model.

Previous studies have demonstrated that Medicare risk-adjusted capitation models do not adequately compensate programs serving primarily disabled or frail populations. Using the Medicare Current Beneficiary Survey, we demonstrate that the Centers for Medicare and Medicaid Services-Hierarchical Condition Categories (CMS-HCC) model calculates Medicare capitation payments for Parkinson's patients more accurately than for the general population. The discrepancies between the predicted and actual expenditures estimated at various disability levels were smaller for Parkinson's patients than for other beneficiaries. If the CMS-HCC payment model were to apply to programs that draw a significant percentage of their participants from the Parkinson's disease community, these programs likely would be compensated fairly.

Aged↗
PubMed1996

Gasless laparoscopic resection of hepatocellular carcinoma (HCC) in cirrhosis.

Liver resection by open surgery remains the method of choice for treatment of hepatocellular carcinoma (HCC) in cirrhotic patients with compensated liver function. Laparoscopy for surgical treatment of hepatic diseases is at an early stage. Laparoscopy has been often proposed for diagnosis, staging of hepatic malignancy, treatment of hepatic cyst or benign tumors, but very few laparoscopic treatments of hepatic malignancies have been reported at present and always using conventional CO2 laparoscopy. We describe herein the operative treatment of a single subglissonian HCC of segment III in a child, HCV (hepatitis C virus)-related cirrhosis. A nonanatomical wedge resection was performed by gasless laparoscopic technique using a mechanical retractor obviating the creation of the pneumoperitoneum and of the sealed environment. The technique, in selected cases, is a simple, safe, and effective surgical method. The gasless technique guarantees a clear vision, it makes possible the continuous suction of smoke and fluids, it allows the use of conventional instruments for classic maneuvers of the liver surgery (Pringle maneuver), and the easy management of suturing. The present case has proved to be another abdominal procedure that can be carried out with all the advantages of gasless minimally invasive surgery.

Aged↗
PubMed2001

Subchronic inhalation toxicity of the chlorinated propane 1,1,1,3,3,3-hexachloropropane (HCC-230fa).

Male and female rats were exposed by inhalation (whole body) to HCC-230fa (1,1,1,3,3,3-hexachloropropane) for 6 h/day, 5 days/week over a 15-week period. Concentrations of 0, 0.50, 2.5, and 25 ppm were studied. A total of eight groups/sex were exposed. Four groups of male and four groups of female rats were used to measure clinical signs and growth, clinical pathology, and tissue pathology. The remaining four groups of male rats were used for immunotoxicological and sperm assessment evaluations, and the remaining four groups of female rats were used for immunotoxicological evaluation. Following the exposure period, surviving male rats were kept for a 1- or 3-month recovery period. Male and female rats exposed to 25 ppm had lower mean body weights, mean body weight gains, and food consumption during the exposure period. Male and female rats exposed to 25 ppm and sacrificed immediately after the exposure period had minimally decreased total leukocyte and lymphocyte counts. These changes were considered to be marginally adverse. Pathologic examination revealed hepatocellular hypertrophy in 0-day recovery males and an increased incidence and/or severity in chronic progressive nephropathy in 0-day, 1-month recovery, and 3-month recovery males at 25 ppm. No other pathological changes, including the testis, epididymis, and other accessory sex organs, were noted in rats during the study. Evaluation of sperm parameters at the end of the exposure period showed statistically significant decreases in epididymal sperm number per cauda epididymis, percent motile sperm, and percent normal sperm morphology at 25 ppm. The biological significance of the slight changes observed in the sperm parameters in the absence of histopathological changes is unclear. After a 1-month recovery period, no biologically significant differences in sperm parameters were noted at 25 ppm compared with controls. Exposure to HCC-230fa did not significantly alter the primary humoral immune response to sheep red blood cell (SRBC). Under the conditions of this study, the no-observed-adverse-effect level (NOAEL) was considered to be 2.5 ppm.

Administration, Inhalation↗
PubMed2006

Multivariate and univariate analysis of prognostic factors following resection in HCC: the Birmingham experience.

BACKGROUND: The aim of this study was to look into our experience of resection for hepatocellular carcinomas (HCCs) in a tertiary Hepatobiliary and Liver Transplant Unit in the UK. METHODS: A retrospective analysis of our prospective database was carried out. RESULTS: 715 cases of HCC were seen. 100 (13.9%) underwent hepatic resection and 159 (22.2%) orthotopic liver transplant. The 1-, 3- and 5-year overall survival following resection was 75.3, 37.0 and 21.5% respectively. Factors affecting long-term survival included resection margin (p < 0.001), recurrence (p < 0.007), alpha-fetoprotein >50 (p < 0.001) and serum albumin (p < 0.03). On multivariate analysis, recurrence (p < 0.001) and histological grade (p < 0.044) were significant. The 1- and 3-year recurrence rates were 27.3 and 72.5% respectively. Histological grade (p < 0.007), alpha-fetoprotein >50 (p < 0.033), female gender (p < 0.016) and portal vein involvement (p < 0.016) were significant in recurrence. CONCLUSIONS: Resection data from the East may not be comparable to the West owing to the higher transplant activity in the latter. Liver function tests and imaging would be sufficient to assess liver function prior to hepatic resection. HCC with cirrhosis should be assessed by a transplant unit prior to any treatment. The MELD (Model for End-Stage Liver Disease) score would be a valuable preoperative tool in the assessment of cirrhotics.

Adult↗
PubMedDate not supplied

Determination of the oncogenes p53 and C-erb B2 in the tumour cytosols of advanced hepatocellular carcinoma (HCC) and correlation to survival time.

UNLABELLED: Mutations in the p53 gene are the most frequently reported somatic gene alteration in human cancer. Overexpression of the oncogene c-erb B2 takes place also in many human carcinomas, esp. in cancers of the breast, colon and ovary. High values of both oncogenes correlate with poor prognosis. We analysed the concentration of p53 in tumor cytosols of 34 primary advanced HCC and with the clinical outcome and survival time. p53 was analysed in the tumor cytosol by luminometric immunoassay (LIA) using monoclonal antibodies detecting wild type and mutant p53 protein. C-erb B2 protein is analysed by a monoclonal ELISA. p53 values vary from 0 to 8.1 ng/mg protein (p) with a median = 0.1 ng/mg p. C-erb B2 values range from 0.02 to 4.53 U/microgram p with a median = 0.43 U/microgram p. Patients with p53 values > 0.1 ng/mg p. had shorter 1 year (20%) and 2 year (13%)--survival times compared to 60% and 20% in patients with p53 values < 0.1 ng/mgp. Patients with cerbB2 > 0.43 U/microgram p. had significantly shorter 1 year (20%) and 2 year survival times (10%) than patients with values < 0.43 U/microgram p (1 year survival = 56% and 2 year survival = 22%; p < 0.05). CONCLUSION: p53 and c-erb B2 seem to be valuable prognostic factors in HCC.

Biomarkers, Tumor↗
PubMed1998

[Establishment of a human hepatocellular carcinoma (HCC) cell line with high metastatic potential (MHCC97) and its biological characteristics].

OBJECTIVE: To establish and characterize a human hepatocellular carcinoma cell line with high metastatic potential derived from a subcutaneous xenograft of metastatic human HCC in nude mice (LCI-D20). METHODS: Single-cell suspension collected by tearing tumor tissues with forceps was transferred to the tissue culture flasks for culture in vitro in medium DMEM supplemented with 10% human group AB serum. Cytogenetic studies were performed on this cell line using flow cytometry and chromosome G-banding. AFP of theprimary xenografts and lung metastatic lesions was detected by using ABC immunohistochemistry. The rates of its tumorigenicity and metastasis in nude mice were evaluated. RESULTS: The MHCC97 cells showed typical epithelial appearance. Upon subcutaneous or intrahepatic inoculation in nude mice, the xenograft grew and metastasized to the lungs. The metastatic rate was 100%. The cancer cells of lung metastatic foci were AFP positive. Aberrant chromosomes i(1)(q) and der(4) (pter-->q35::?) were its chromosome markers. CONCLUSION: The MHCC97 cell line maintained the biologic characteristics as its original xenografts. The presence of the reported chromosomal aberrations may be related to carcinogenesis and progression of HCC.

Adult↗
PubMed2000

[Comparison of detection pattern of HCC by ferumoxide-enhanced MRI and intratumoral blood flow pattern].

We compared the detection rate and pattern of ferumoxide-enhanced magnetic resonance imaging (Fe-MRI) with the intratumoral blood flow pattern determined by CT angiography (CTA) and CT portography (CTAP) in 124 nodes (34 cases) diagnosed as hepatocellular carcinoma (HCC) or borderline HCC, based on the clinical course. Sequences to obtain a T1-weighted images (T1W), proton density-weighted images (PDW), T2-weighted images (T2W), T2*-weighted images (T2*W) were used in Fe-MRI. In nodes shown to be hypervascular on CTA, the detection rate by Fe-MRI was 69.7%. In nodes shown to be avascular by CTAP, the detection rate by Fe-MRI was 67.3%. These rates were higher than with other flow patterns. In nodes showing high signal intensity (HSI) on any sequences, arterial blood flow was increased and portal blood flow decreased in comparison with nodes without high signal intensity. All nodes showing HSI, both on Fe-MRI T2W and T2*W, were hypervascular on CTA, and portal blood flow was absent on CTAP. Nodes showing HSI on both T2*W and T2W were considered to have greater arterial blood flow and decreased portal blood flow compared with nodes appearing as HSI on T2*W, but only as iso- or low signal intensity on T2W (Mann-Whitney U-test; p < 0.05).

Aged↗
PubMed2001

[Overexpression of p27(KIP1) induced by Bak gene leads to the arrest in G(1) phase of HCC-9204 cell line].

OBJECTIVE: To explore whether p27(KIP1) plays an important role in prolonging cell cycle in G(1) phase and leading to apoptosis of HCC-9204 cells. METHODS: A model of Bak-induced cell cycle arrest in G(1) phase and subsequent apoptosis was established. p27(KIP1) was obtained from the model and sequenced afterwards. A zinc inducible p27(KIP1) stable transfectant was constructed. The effects of inducible p27(KIP1) on cell growth and cell cycle arrest were examined in control pMD and pMD-KIP1 transfected HCC-9204 cells. Western blot was performed to evaluate the expression of p27(KIP1). RESULTS: The cell growth was reduced by 35% upon 48h of p27(KIP1) induction with zinc treatment as determined by trypan blue exclusion assay. p27(KIP1) caused cell cycle arrest at 24h after induction, with 40% increase in G(1) population. CONCLUSIONS: Bak may induce cell cycle arrest in G(1) phase through up-regulating expression of p27(KIP1). The inducible p27(KIP1)-expressing cells provide a model to assess p27(KIP1) function.

Apoptosis↗
PubMed1998

[Dynamic change of androgen-receptor in tumor and surrounding liver tissue of nude mice model with transplanted human HCC].

OBJECTIVE: To research into the law of androgen-receptor (AR) dynamic change in developing course of human HCC. METHOD: Dynamic measurement of AR in tumor and peritumorous tissue was performed in nude mice model with orthotopic transplanted human HCC. RESULT: Tumor nodules were present in 90% nude mice 4 weeks after transplantation, tumor necrosis was found in the 10th week, and remarkable necrosis occurred in the 12th week. The quantity of AR in tumor and peritumorous tissue was highest in the early stage of tumor (102.32 +/- 21.42 fmol/mg protein and 72.45 +/- 10.11 fmol/mg protein respectively), and then decreased progressively with time to the 10th week (40.98 +/- 21.11 fmol/mg protein and 53.39 +/- 7.01 fmol/mg protein respectively). The difference in AR between each two weeks was significant. CONCLUSION: Androgen promotes the development of tumor because of existence of AR, and its action may decline after establishment of tumor. Therefore, antiandrogen treatment may be ineffective after establishment of tumor.

Animals↗